A double-edged win for all Oregonians

In the coming days, our legislators have an opportunity to bring health care coverage to as many as 150,000 children and adults by renewing and restructuring the current provider tax on insurers and large hospitals. This will allow us to receive more than a billion dollars in federal funds for the Oregon Health Plan and support Oregon's economy. This is an economic stimulus, as well as the only responsible way to begin improving health care for all Oregonians.

It would be a win for all Oregonians, generating jobs and improving health.

It would be a win for nurses, doctors, community clinics and hospitals, who would see more paying patients. It would be a win for the 2 million Oregonians who pay higher health insurance premiums to indirectly cover the cost of caring for the uninsured.

The cost shift in health care is real. It happens every time that someone without insurance shows up in an emergency room. Expensive treatment and delayed care of the uninsured add millions to our insurance rates every year, which inflates health insurance premiums for small businesses, individuals and large employers.

So why not use funds already in our health care system to secure that billion dollars in unused federal funds and cover 150,000 Oregonians? Not now, some say, the economy is on the rocks. Not this way, say others, who prefer different taxes to pick up the tab for expanding health care coverage. But the naysayers propose no alternative that would achieve the federal matching funds. They would leave federal money on the table instead of finding a responsible solution.

To be clear, every dollar raised by a provider tax would be returned to the providers along with two additional dollars. Looked at fairly, this is not an additional cost for health care providers, but a way of bringing them new money. If health care providers are fairly paid for treating people who are now uninsured, they can and should reduce their charges to everyone else.

It's not enough to cover more individuals with medical insurance. We have to simultaneously achieve cost reductions in health care.

Our legislators are considering a detailed health reform proposal from the Oregon Health Fund Board that would give Oregon essential tools to address the rising costs of health care: for example, a system that allows consumers to compare the cost and quality of health care and reforms provider payment to reward prevention and primary care.

The provider tax is not a perfect or permanent solution to improving access, but it's the only practical point of beginning. We don't know today if there will be federal health reform legislation or how it might work. Over the next two years, we must implement major changes in how we think about and provide health care to all Oregonians, resulting in high-quality, affordable health care for everyone.

It would be unconscionable, however, for us to delay or water down the provider tax concept, which is the best step available to expand coverage now and stem the tide of the uninsured in Oregon.

Jonathan Ater is a Portland lawyer and vice chairman of the Oregon Health Fund Board.